Integrative Psychoanalytic Couple Therapy Application

Instructions and Information

Please fill in the items below. Along with the application and $100 Application Fee (non-refundable and made out to Chicago Psychoanalytic Institute), please submit the following items:

2 References
Curriculum Vitae/Resume
Brief Personal Statement
Copy of your professional license

General Information

Required for: PEP, PSP, PPP

Employer Information


Admissions Documents

Payment Options

If you select the ACH or Bank Transfer Payment method, the Institute will email you an Invoice which will contain a payment link. The Transaction fee will be 1.5% of the Total Balance or $1.00, whichever is larger.
If you select payment by Credit or Debit card, after you click the Submit Application button, you will be directed to a payment page to enter your card information. Students paying by ACH or Bank Transfer will need to ignore the Payment page


(Please skip this section if you chose ACH or Bank Transfer option above.) Would you like your Credit/Debit card auto charged? This allows us to save your card information to process future payments.


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